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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566206746
Report Date: 04/02/2025
Date Signed: 04/02/2025 01:26:27 PM

Document Has Been Signed on 04/02/2025 01:26 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:GUTIERREZ FAMILY CHILD CAREFACILITY NUMBER:
566206746
ADMINISTRATOR/
DIRECTOR:		MARIA GUTIERREZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 336-9215
CITY:OXNARDSTATE: CAZIP CODE:
93033
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
04/02/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:15 AM
MET WITH:Maria GutierrezTIME VISIT/
INSPECTION COMPLETED:
01:35 PM
NARRATIVE
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 On April 2, 2025 at 11:15 AM Licensing Program Analysts(LPAs) Laura Carone and Cynthia Alvarez conducted an unannounced Case Management-Deficiencies inspection. LPAs met with Licensee, Maria Gutierrez and explained the purpose of the visit. LPAs conducted a tour of the facility inside and outside with Licensee. LPAs observed a total of 3 children under the care and supervision of Licensee and Assistant.

During inspection on 01/13/2025, LPA Laura Carone observed S1 interacting with children. Licensee stated that she was her assistant. S1 does not have fingerprint clearance. LPA informed S1 that she will need to have her fingerprints taken and wait for a clearance letter before providing care for children. LPA provided S1 with a letter from the Department of Social Services dated 08/02/2024 requesting action from S1 for her fingerprints. The letter states that the Live Scan fingerprints includes either an incorrect agency number or the agency number is missing. S1 was given until 10/30/2024 to complete or background check will be closed. Licensee stated that S1 is no longer assisting with child care due to her employed at a law firm.

LPA interviewed parents for a complaint dated 01/09/2025 and parents informed LPA that Licensee's husband and S1 provide care and supervision to children in care. LPA asked Licensee for assistants Mandated Reporter Training, immunizations, and CPR/First Aid Training. Licensee called doctor's office and verified her husband has MMR and Tdap immunizations. He will be opting out of the flu shot with a written statement. Husband will be completing Mandated Reporter Training and CPR/First Aid. S2 completed Mandated Reporter Training on 1/13/2024. S2 will be obtaining immunization record from her physician.

LPA explained that a clearance letter is sent when an individual's fingerprints have been cleared. Only then
CONTINUED ON LIC809C
Susana MartinezTELEPHONE: (805) 562-0400
Laura CaroneTELEPHONE: (805) 722-5138
DATE: 04/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/02/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 04/02/2025 01:26 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117


FACILITY NAME: GUTIERREZ FAMILY CHILD CARE
FACILITY NUMBER: 566206746

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/02/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/02/2025
Section Cited
CCR
102416(d)(2)(d)

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102416(d)(2):(d) Personnel Records(d) Prior to employment or initial presence..a criminal record review shall: .(2) Request a transfer of a criminal record ...in Section 102370(j). This requirement was not met
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Licensee stated that she will have her granddaughter go and have fingerprints retaken.
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as evidenced by: During inspection on 01/13/2025, LPA observed S1 caring for children, the individual was not associated to the facility. Per Guardian S1 is not listed on roster. This is an immediate risk to the children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Susana MartinezTELEPHONE: (805) 562-0400
Laura CaroneTELEPHONE: (805) 722-5138

DATE: 04/02/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/02/2025

LIC809 (FAS) - (06/04)
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Document Has Been Signed on 04/02/2025 01:26 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117


FACILITY NAME: GUTIERREZ FAMILY CHILD CARE
FACILITY NUMBER: 566206746

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/02/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/02/2025
Section Cited
CCR
102416.1(a)

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(a) Personnel records shall be maintained on each employee and shall contain the following information: This requirement is not met as evidenced by: On 1/11/24 during an annual inspection Licensee was cited for not
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Licensee will create a file for each of her assistants by 4/11/2025 and submit proof to LPA via email:laura.carone@dss.ca.gov
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having a file for her assistants. Licensee still does not have a file for her assistants.
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Type B
04/02/2025
Section Cited
HSC1596.8662(b)(1)

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(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider,..date on which he or she completed the initial mandated reporter training. This requirement was not met as evidenced by:
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S1 does not have Mandated Reporter Training completed. On 1/11/2024, Licensee was given a technical violation for assistants not completing Mandated Reporter Training.
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Assistant will complete Mandated Reporter Training and Licensee will submit proof to LPA by 05/02/2025.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Susana MartinezTELEPHONE: (805) 562-0400
Laura CaroneTELEPHONE: (805) 722-5138

DATE: 04/02/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/02/2025

LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: GUTIERREZ FAMILY CHILD CARE
FACILITY NUMBER: 566206746
VISIT DATE: 04/02/2025
NARRATIVE
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can an adult be present in the child care home. A type A citation was issued section 102416(d)(2):(d) Personnel Requirements. Two type B citations were issued for Personnel Requirements section 102416.1(a) and Health & Safety Code(Mandated Reporter Training) section 1596.8662(b)(1).

Notice of Site Visit (LIC9213) will be posted. The notice shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty. Appeal rights were given LIC9058.
LPAs Laura Carone and Cynthia Alvarez informed licensee, Maria Gutierrez that this report dated 04/02/2025 documents 1 Type A citation and 2 type B citations which shall be posted for 30 consecutive days as this is an immediate risk to the health, safety, or personal rights of children in care. Also, LPAs Laura Carone and Cynthia Alvarez informed the licensee to provide a copy of this licensing report dated 04/02/2025 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview conducted with licensee, Maria Gutierrez.
SUPERVISOR'S NAME: Susana MartinezTELEPHONE: (805) 562-0400
LICENSING EVALUATOR NAME: Laura CaroneTELEPHONE: (805) 722-5138
LICENSING EVALUATOR SIGNATURE:

DATE: 04/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2025
LIC809 (FAS) - (06/04)
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